Arch Intern Med
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Increased Clostridium difficile-associated disease (CDAD) in a hospital and an affiliated long-term care facility continued despite infection control measures. We investigated this outbreak to determine risk factors and transmission settings. ⋯ The hospital outbreak of CDAD was caused by transmission of a more virulent, fluoroquinolone-resistant strain of C difficile. More selective fluoroquinolone and proton pump inhibitor use may be important in controlling and preventing such outbreaks.
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Transitions between health care settings represent vulnerable periods for medical error. Discontinuation of long-term medication use may occur during discharge from the hospital to the community. ⋯ Patients prescribed long-term therapy with warfarin were at risk for potentially unintended medication discontinuation after elective procedures. Patients prescribed statins or beta-blocker ophthalmic drops were not at increased risk.
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Recent reports have highlighted the poor standard of cardiopulmonary resuscitation (CPR) achieved by health care professionals in diverse situations. We explored what can be achieved in an emergency department by highly trained permanent staff. ⋯ Highly trained professionals in an emergency department can achieve appropriate chest compression rates during CPR with a low hands-off ratio. Increased attention must be paid in all situations to the avoidance of hyperventilation.
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Previous studies of lower urinary tract symptoms (LUTS) have focused on men, with few studies including minority populations. The Boston Area Community Health (BACH) Survey is designed to study the prevalence and impact of LUTS among both men and women in a racially, ethnically, and socioeconomically diverse population. ⋯ In this population-based, racially and ethnically diverse random sample, LUTS were common among both men and women and increased substantially with age. Lower urinary tract symptoms had a negative impact on quality of life across age, sex, and race/ethnic groups.